Recognizing Mental Illness In Youth

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Sally Buchanan-HagenWhen I was 14 I wanted to die. I was constantly sad, had no energy, didn’t want to leave the house and everything in my world turned grey.

That episode of depression ended after a year, but it returned and worsened year after year. After six years, I went to my university professor for help. She referred me to the university counselor, who I saw for two years before a psychiatrist diagnosed me with bipolar disorder after a psychotic manic episode. My professor saved my life. If I hadn’t gone to her when I did, I’m sure I would have killed myself.

In the United States, 1 in 5 people between the ages of 13 to 18 experience a serious mental health condition in any given year. Fifty percent of mental illnesses begin before the age of 14 and 75 percent by the age of 24. Yet young people are reluctant to seek help due to self-stigma and failure to recognise symptoms of mental illness.

Those who work closely with young people are in a position to identify signs of mental health problems and help affected individuals.

It can be difficult to distinguish normal adolescent moodiness and behavior from a mental illness. However, asking someone you are worried about if they are OK can open up conversation and avenues to help. People underestimate the power of talking and listening. What can seem like a small and insignificant gesture can save a life.

Adopting a nonjudgmental and open attitude encourages people to open up. Ask them openly about the symptoms they are experiencing and validate them. If confident in doing so, provide education and solutions. Establish confidentiality but also set clear limits, such as potentially involving someone else if a situation is harmful to the youth or to others.

Avoid telling the person what they are experiencing is in their head because this can trivialize their symptoms and doesn’t encourage further conversation. Remember what they’re experiencing is real to them — especially delusions or hallucinations.

Sometimes teens’ mental health problems may require the help of other health care professionals. Being familiar with local mental health services is important for referrals. The youth’s family doctor can be a valuable resource and educate them about the services available.

If you’re worried, never be afraid to contact the young person’s parents, guardians or teachers. If the teen is very distressed, they may need emergency care to keep them safe, so know the local psychiatric emergency team’s phone number. When dealing with an emergency, it’s recommended to remain nonthreatening but be honest and direct.

Avoid confrontation to prevent the situation from escalating. Unless it is essential to keep the person safe, do not manhandle them. Address what the person sees as major issues and take what they say seriously. Try to keep the situation as calm as possible while waiting for further help.

Identifying mental illness in adolescents can be hard. However, sudden uncharacteristic emotional and behavioral changes can be a sign of a mental health problem.

Causes of mental illness include genetics, certain environmental exposures and brain chemistry. Risk factors that may increase the chance of a person developing a mental health problem are: exposure to illicit drugs and alcohol, having a biological relative with a mental illness, loss and grief, traumatic experiences, having few social supports and childhood abuse and neglect.

Schizophrenia, mood disorders, anxiety disorders, eating disorders and personality disorders typically arise in adolescence or early adulthood.

Depression is one of the most common mental illnesses experienced by youth but it can sometimes present differently than in adults, with teens experiencing increased irritability and moodiness. Other symptoms include social withdrawal, loss of pleasure, constant feelings of hopelessness, emptiness or sadness, excessive crying and changes in academic performance.

When I am depressed my whole demeanor changes. People often comment on my deadened facial expression, slowed reactions and flat affect.

Bipolar syndrome in adolescence includes symptoms of depression and elevation of mood (hypomania or mania) and is cyclic in nature. Both mood states are significantly different from the youth’s baseline mood. Symptoms of elevation include increased energy and little need for sleep, rapid speech, unusually cheerful, jumping from topic to topic in conversation, subjective racing thoughts, labile mood, impatience, agitation, impulsivity and, in extreme cases, psychosis.

For me, being manic is like being on fast-forward while everyone else is on pause.

Signs of possible schizophrenia in youth are changes in concentration, confusing reality with fantasy (for example, confusing real life with TV shows or dreams), paranoia, hallucinations or delusions, inappropriate emotional responses (such as laughing when something sad happens) and increasing self-isolation.

Anxiety in teens may appear to others as difficulty in concentrating, excessive worrying or withdrawing from social groups. Physical symptoms can include the sensation of “butterflies” in the stomach, nausea, sore muscles, palpitations and difficulty breathing.

I will always remember the day that I went to speak to my professor as the catalyst for getting professional help. Listening to someone who is experiencing psychological distress is extremely important and lets them know they are not alone.

Sally Buchanan-Hagen works as a nurse in the emergency department, is currently completing her honors degree in nursing and blogs for the International Bipolar Foundation. She was diagnosed with bipolar affective disorder when she was 22 and is now passionate about mental health promotion.